Comparison of robot-assisted esophagectomy and thoracoscopic esophagectomy in esophageal squamous cell carcinoma

Abstract Background Recently, induction chemotherapy with docetaxel, cisplatin, and 5-fluorouracil (DCF) has been reported effective for T4 esophageal squamous cell carcinoma. The aim of this study was to investigate the safety and feasibility of thoracoscopic esophagectomy (TE) as conversion surgery after DCF for T4 esophageal squamous cell carcinoma. Methods Medical records of 64 consecutive patients with T4 (with or without distant metastasis) thoracic esophageal squamous cell carcinoma treated with induction DCF chemotherapy were reviewed. Twenty-tree patients underwent conversion TE after induction DCF. Results The invading organs of T4 tumor were tracheobronchus in 8 patients, thoracic aorta in 13 patients, and pericaridium and diaphragm in 3 patients each. Average courses of DCF treatment were 2.8 courses. The mean total operation time was 556.3 min and that of the thoracic procedure was 258.9 min. The mean blood loss was 166.2 mL and that during the thoracic procedure was 33.5 mL. All patients underwent complete resection under TE. No patient experienced accidental conversion to open thoracotomy or intraoperative morbidity including adjacent organ injury. Postoperative morbidity rate was 34.8%. There were no serious complications related to surgery requiring reoperation. Postoperative hospital stay was 24.3 (range, 13–38) days. Five patients had recurrence: four had distant metastasis (lung (2), liver (3), one patient had overlapped), and one had mediastinal lymph node recurrence. There was no local recurrence at the site of primary T4 tumor. Conclusion TE as conversion surgery after DCF therapy for initial T4 esophageal squamous cell carcinoma can be safely performed. The strategy of induction DCF followed by conversion TE could be an alternative in the treatment for T4 advanced esophageal squamous cell carcinoma. Disclosure All authors have declared no conflicts of interest.

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236P Comparing chemo-radiotherapy with 5-fluorouracil and cisplatin versus thoracoscopic esophagectomy for cStage II- III esophageal squamous cell carcinoma

Annals of Oncology ◽

10.1016/s0923-7534(21)00393-8 ◽

2016 ◽

Vol 27 ◽

pp. ix74

Author(s):

T. Kashiwada ◽

Y. Harada ◽

Y. Yoda ◽

H. Noshiro ◽

N. Aragane ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Esophageal Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Thoracoscopic Esophagectomy

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Robot-Assisted Versus Conventional Minimally Invasive Esophagectomy for Resectable Esophageal Squamous Cell Carcinoma

Annals of Surgery ◽

10.1097/sla.0000000000005023 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Yang Yang ◽

Bin Li ◽

Jun Yi ◽

Rong Hua ◽

Hezhong Chen ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Esophageal Squamous Cell Carcinoma ◽

Minimally Invasive ◽

Cell Carcinoma ◽

Squamous Cell ◽

Minimally Invasive Esophagectomy ◽

Robot Assisted ◽

Invasive Esophagectomy ◽

Resectable Esophageal

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Comparative outcomes of robot-assisted minimally invasive versus open esophagectomy in patients with esophageal squamous cell carcinoma: a propensity score-weighted analysis

Diseases of the Esophagus ◽

10.1093/dote/doz071 ◽

2019 ◽

Vol 33 (5) ◽

Cited By ~ 5

Author(s):

J K Yun ◽

B K Chong ◽

H J Kim ◽

I-S Lee ◽

C-S Gong ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Propensity Score ◽

Esophageal Squamous Cell Carcinoma ◽

Minimally Invasive ◽

Cell Carcinoma ◽

Squamous Cell ◽

Esophageal Surgery ◽

Robot Assisted ◽

Open Esophagectomy

SUMMARY Robots are increasingly used in minimally invasive surgery. We evaluated the clinical benefits of robot-assisted minimally invasive esophagectomy (RAMIE) in comparison with the conventional open esophageal surgery. From 2012 to 2016, 371 patients with esophageal squamous cell carcinoma underwent an Ivor Lewis or McKeown procedure at our institution. Of these, 130 patients underwent laparoscopic gastric conduit formation followed by RAMIE, whereas 241 patients underwent conventional esophageal surgery, including laparotomy and open esophagectomy (OE). We compared the short- and long-term clinical outcomes of these patients using the propensity score-based inverse probability of treatment weighting technique (IPTW). Among the early outcomes, the OE group showed a higher incidence of pneumonia (P = 0.035) and a higher requirement for vasopressors (P = 0.001). Regarding the long-term outcomes, all-cause mortality was significantly higher (P = 0.001) and disease-free survival was lower (P = 0.006) in the OE group. Wound-related problems also occurred more frequently in the OE group (P = 0.020) during the long-term follow-up. There was no statistical intergroup difference in the recurrence rates (P = 0.191). The Cox proportional-hazard analysis demonstrated that wound problems (HR 0.16, 95% CI 0.02–0.57; P = 0.017), pneumonia (HR 0.23, 95% CI 0.06–0.68; P = 0.019), and use of vasopressors (HR 0.14, 95% CI 0.08–0.25; P = 0.001) were independent predictors of mortality. RAMIE could be a better surgical option for selected patients with esophageal squamous cell carcinoma.

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